Time Use of Stroke Patients with Stroke Admitted for Rehabilitation in Skilled Nursing Facilities

Authors

  • Chantal J.A.H.R. Vermeulen MSc, RN,

    Corresponding author
    1. Vitalis Behandel Groep, Eindhoven, The Netherlands
    • Correspondence

      C. J. A. H. R. Vermeulen, Vitalis Behandel

      Groep, PO Box 925, 5600 AX Eindhoven, The Netherlands.

      Email: c.vermeulen@vitalisgroep.nl

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  • Bianca I. Buijck MSc, RN,

    1. Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, the Netherlands
    2. De Zorgboog, Bakel, The Netherlands
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  • John C.G.H. van der Stegen MD,

    1. Vitalis Behandel Groep, Eindhoven, The Netherlands
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  • Monica Spruit- van Eijk MD,

    1. Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands
    2. SVRZ, Middelburg, The Netherlands
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  • Raymond T.C.M. Koopmans MD, PhD,

    1. Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands
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  • Thóra B. Hafsteinsdóttir PhD, RN

    1. SVRZ, Middelburg, The Netherlands
    2. Department of Rehabilitation, Nursing Science and Sport, Rudolf Magnus Institute, University Medical Center Utrecht, Utrecht, The Netherlands
    3. Clinical Health Sciences, Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
    4. Research Centre for Innovations in Health-care, University of Applied Science Utrecht, Utrecht, The Netherlands
    5. Faculty of Nursing, University of Iceland, Reykjouik, Iceland
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Abstract

Purpose

To describe the time use of patients with stroke in five Skilled Nursing Facilities (SNFs) in the Netherlands, focusing on the time spent on therapeutic activities, nontherapeutic activities, interaction with others, and the location where the activities took place.

Evidence suggest that task-oriented interventions are the most effective for patients with stroke and that some of these interventions are relevant and feasible for use by nurses. The question arises to what extent elderly patients who had a stroke and rehabilitate in a SNF receive therapeutic training and engage in therapeutic activities.

Design

Descriptive, observational design. Therapeutic and nontherapeutic activities of patients were observed at 10-minute intervals during one weekday (8 a.m.–4:30 p.m.) using behavioral mapping.

Findings

Forty-two patients with stroke with a mean age of 76 years participated in the study. The patients spent 56% of the day on therapeutic activities, whereas 44% of the day was spent on nontherapeutic activities. Most therapeutic time was spent on nursing care (9%) and physical therapy (4%). Patients stayed an average 41% of the day in their own room and were alone 49% of the day. Therapeutic time use was significantly related to improved functional status, patients with higher functional status spent more time on therapeutic activities.

Conclusion

Patients spent more than half of the day on therapeutic activities.

Clinical relevance

Nurses are faced with the challenge of activating patients with stroke and to assist them to engage in purposeful task-oriented exercises including daily activities. Thereby better rehabilitation results and recovery of patients may be reached.

Ancillary